Senior Care Records.

Facility Evaluation Report

Mount Blue Residential Care Home INC, San Jose02/09/2022Licence 435202656

Capacity6
Census6
Date signed02/11/2022 02:58:33 PM
The inspector’s account

Licensing Program Analyst (LPA) Steve Chang, and Licensing Program Manager (LPM) Romeo Manzano, conducted Technical Assistant through tele-inspection (Zoom), and met with Administrator (ADM) FREDRICKA SAFAR.

The purpose of this TA Tele visit was to review the facility COVID-19 infection mitigation plan and conducted inspection of the facility to ensure plan is being carried out and to provide support and guidance to staff in mitigating the spread of virus.

During tele-visit inspection, a tour of the facility was conducted which started at the main entrance to check COVID-19 signage and screening procedures. The facility has the COVID-19 posters at the main entrance including hand sanitizer, face masks, thermometer, glove, and a visitor log book at the screening station.

The facility common areas were inspected such as the kitchen, living room, family room, dinning area, and bathrooms were observed. There are 3 resident bedrooms, three bathrooms in facility. Trash cans were observed with covers. Paper towels with holders were observed. Some washing hands signs by the sinks were observed. Cloth towels were observed in the restrooms and kitchen. The resident bedrooms were observed. The beds in the bedrooms were observed 6 feet apart. ADM stated all the residents and staff are fully vaccinated and done with boosters. ADM request CCL office to provide PPEs. CCL office will prepare the PPEs for ADM to pick up.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction